Incidental Finding During Venous Duplex Examination: Solitary Fibrous Tumor or Arteriovenous Malformation in the Left Lower Extremity

Authors: Hodge, Megan; Hund, Twyla; Bush, Ruth; Lumsden, Alan B.; McCollum, Charles H.; Noon, George P.

Source: Journal for Vascular Ultrasound, Volume 31, Number 1, March 2007 , pp. 41-44(4)

Publisher: Society for Vascular Ultrasound

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Abstract:

Purpose.—Superficial varicosities surrounding a palpable mass in the posterior aspect of the left thigh were investigated during a venous duplex examination. A well-defined mass with arterial and venous feeding branches strongly suggested the presence of an arteriovenous malformation. We present an unusual case of a soft-tissue thigh mass that appeared to be an arteriovenous malformation by ultrasound and arteriography but after surgical resection was confirmed to be a benign soft tissue tumor.Case Report.—A 32-year old woman presented with superficial varicosities surrounding a painful mass on the posterior aspect of her left thigh. Venous duplex exam demonstrated normal findings of the deep veins, but further investigation of the superficial varicosities revealed a 3.5-cm × 6.0-cm soft-homogenous mass with a large complex network of arterial and venous feeding branches. Arteriography confirmed a well-defined thigh mass with an arterial network feeding the mass. Surgical resection of this well-circumscribed mass was performed. Histological tissue exam revealed a benign low-grade spindle cell neoplasm with blood vessels.Conclusion.—This report highlights the importance of evaluating all abnormal superficial varicosities and palpable soft-tissue masses as part of a lower extremity vascular duplex evaluation because incidental findings not diagnosed through clinical examination may be detected.

Document Type: Case report

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